Valley R Plaza A-PT 970311Bore/Excavation in Public Right-Of-Way Permit
City of Coppe!l - Public Works Department
Da~e: 3 / // i ~7 Project Name:
Permit Issued To: Name:
Address:
Phone:
Emergency Phone:
Representing:
.Insp~%or:
Type of Work/General Description:
llave ~1 Cimy and/or Franchise U~i~tie~ Been Contacted and
Existinq utilities Located:~ YES
~ill It Be Necess~ to Excavate Street, ~ley or Sidewalk
Payment? YES (a~tach pe~it) / NO
Representative(s) of the Franchise/Contractor must adhere to all
constructiom s~andards approved by the City of Coppell, which
includes but i5 not limited =o: Compaction of Trenches and Bores,
and Barricading according to =he Texas ~nual on Unifo~ Traffic
Control Devices. ~ea(s) affected must be restored to as good
condition as before the co~encement of work.
Any excavation requiring closing of a street or alley must be
reported to the Police, Fire, and public Workn Depa~_ments prior
to closing (462-1144, 462-1133 and 462-8495).
Attach Work Order (Franchise Only}
PAGE 2
PERMIT
Attach Barricading/Detour Plan if a lane or street closure is
applicable.
Franchise/Contract~Representative
Date'
Franchise Inspector/or City Inspector
Da~e
Apolicant shall indemnify and forever hold harmless against each
an~ eve~! claim, demand o~ cause of action ~ha~ may be made or come
against it by reason of or if any way arising ou~ of the closure,
blocking, excavating, cuffing, ~unneling, or other work by ~he
applicant under permit from the City, if such permit is granted.
PER.MIT. PHB
All contractors will contact Public Works @ 462-8495 to have
trenches and/or open cuts inspected prior to back fill operation
taking place. Staff will be sent to inspect the project.
* NO WET BORES ALLOWED!